Using Needleless Connectors In Clinical Settings

History of Needleless Connectors

Needleless connectors were first introduced to the healthcare industry in the 1990s in response to the high number of needlestick injuries and blood infections. A study that was performed by Jagger, et al., showed that devices that requiring manipulation after the first contact had an increased rate of injury to healthcare professionals.

At a rate of approximately 385,000 sharps-related injuries per year, this increased risk of bloodborne illnesses posed a significant issue for all healthcare professionals.

While needleless connectors do reduce the risk of injury for the healthcare provider and the patient, they carry an increased risk of hospital-acquired bloodstream infection and catheter-related bloodstream infection.

What is a Needleless Connector

Needleless connectors are composed of lightweight plastic that is waterproof, moldable, unaffected by chemicals, silicone, polyester and sometimes, stainless steel. There are several notable design differences, functionality differences, and different characteristics between various types of needle-free systems.

The exterior of a needleless valve is either going to be clear or opaque and has a connection surface that is either flat, concaved, indented or has an angled center.  For the purpose of having the greatest opportunity for disinfection, the most desirable exterior design for the needleless connector is a smooth septum surface with little-to-no gaps or ridges.

When there is a tight seal connecting the septum and the needle-free valve, there is a much lower chance of contamination development. Other features of the needleless connector are no clamping sequences, straight and clear fluid pathway, transparency, there is little-to-no blood reflux, and they are capable of only being flushed with saline.

How A Needleless Connector Works

Focusing on internal functionality, there are two categories to distinguish needleless connectors: simple and complex. Simple needleless connectors account for the majority of needleless connectors.

Simple needleless devices do not contain moving internal pieces. On the other hand, complex connectors not only contain but depend on the movement of internal moving parts for the successful movement of fluid.

The movement of fluid is a characteristic in which needle-free connectors are evaluated. Manufacturers usually describe the movement of fluid as positive, negative, or neutral. Negative movement is where the blood is pulled back to the catheter. Positive movement is where a small amount of fluid is held and then pushed into the catheter upon disconnection. Neutral movement stops fluid from moving into the catheter.

Setting Up A Needleless Connector

When connecting an IV or syringe, there are two ways to connect it utilizing a needleless connector. First, you can manually push the Luer tip of the IV or attached cannula through a split septum. The second option is to take the Luer tip of the IV or attached cannula and Luer-lock it onto the mechanical valve. Regardless of the method, an actual needle is not to be used.

Since there is still conflicting research on the optimal use of needle-free valves, there are different schools of thought on the best practices, policies, and procedures for their proper use and disposal.

Changing A Needleless Connector

Needleless connectors carry an increased risk of catheter-related bloodstream infection. This risk is linked to improper cleaning and flushing of the connectors, IV administration operations, poor clamping methods, and infrequent changing of the connectors.

The CDC guidelines state that needleless connectors should be replaced at the same time intervals as IV sets (every 72-96 hours) or at the time of blood draw. However, there are also healthcare providers that change needleless connectors every 7 days.

Disparities such as this can account for the increased risk of catheter-related bloodstream infection incidents in various hospitals in the United States and internationally. Further, only approximately half of health care providers correctly reported the proper procedure for cleaning needleless connectors.

The lack of uniform policy on how to properly clean, maintain, and use needleless connectors appears to be the sole reason for the rapid increase in catheter-related bloodstream infections. The best way to fix this problem is to first develop a uniform work policy and procedure for the cleaning, flushing, use, material handling, and disposal of the connector.

Once a uniform policy and procedure are created, frequent training must be undertaken by all healthcare providers. If the method updates, additional training should reflect the updated policy and procedure.

Buying Needleless Connectors

As technology and science continue to progress in the healthcare industry, more healthcare providers should make the transition from needlesticks to needleless connectors to protect both healthcare workers and patients.

Although this risk is significant, the risk of getting a bloodborne infection or needlestick injury is far greater by not utilizing a needleless connector. Needleless connectors that are flat, tightly sealed, and directly paved for fluid movement are best for the entire healthcare community-not just patients.

If you’re interested in purchasing needleless connector solutions for your hospital or healthcare system, Preferred Medical carries a great selection of options that are sure to meet your needs. Our customer service representatives are standing by to answer your questions Contact us today toll-free at 800-722-7865. We look forward to hearing from you!